The evaluation and management of palpitations

Palpitations, defined as an awareness of one's heartbeat, is a common complaint, reported by up to 16% of patients during physician office visits. Although palpitations may be indicative of worrisome arrhythmias and sudden cardiac death, they are usually associated with benign etiologies. A systematic approach with a detailed history and physical examination, an electrocardiogram, and selective testing will reveal the etiology in over 80% of cases. Palpitations associated with chest pain, dyspnea, syncope, or cardiac disease are worrisome. Thus, as a primary care physician, the obstetrician/gynecologist must be skilled in detecting cardiac pathology and proficient in the evaluation and management of palpitations.